Reciprocal Relations of Worry,Rumination, and Psychopathology Symptoms After Loss: A Prospective Cohort Study

Bereavement can precipitate symptoms of depression, prolonged grief disorder, and posttraumatic stress disorder. Targeting repetitive negative thought (i.e., worry, rumination) in treatment may help reduce post-loss psychopathology. Yet, evidence on longitudinal associations of depressive rumination and worry with post-loss psychopathology symptoms has been mixed and the directions of effects are still unclear. Recently bereaved adults (78% female) completed questionnaires assessing depressive rumination (brooding), worry, and depression, prolonged grief and posttraumatic stress symptoms 11 times in 1.5 month intervals. We applied random-intercept cross-lagged panel models (RICLPMs) to examine reciprocal within-person associations between worry and psychopathology symptoms, between rumination and these symptoms, and between worry and rumination. Main findings were that worry showed reciprocal relationships with psychopathology symptoms (although worry did not consistently predict prolonged grief symptoms). Depressive rumination was predicted by psychopathology symptoms, but not vice versa. Worry showed reciprocal relations with depressive rumination. Findings suggest that worry may be part of a downward spiral, enhancing psychopathology symptoms following loss, whereas depressive rumination is solely a consequence of such symptoms.     

Cognitive Vulnerability to Emotional Symptoms: Reconsidering the Role of Worry and Rumination

The present study explored the pathways whereby cognitive variables (worry, rumination) may explain the relation between neuroticism and emotional symptoms in a community sample of adults (N?=?499). All participants completed a battery of questionnaires including measures of neuroticism, worry, rumination, anxiety and depression. Multiple mediation and moderated mediation analyses were used. Worry was a common pathway explaining the effect of neuroticism on both anxiety and depressive symptoms. The brooding subtype of rumination significantly mediated the relation between neuroticism and anxiety symptoms, but the reflection subtype did not have a mediating effect. Although worry by itself mediated the association between neuroticism and anxiety symptoms, it required a certain level of brooding to exert its mediating effect on the relation between neuroticism and depressive symptoms. The results are discussed in light of previous research and recent developments in treatment. Clinical implications and suggestions for future research are also discussed.     

Maladaptive coping, adaptive coping, and depressive symptoms: Variations across age and depressive state

Rumination has consistently been found to be associated with the onset and duration of major depressive episodes. Little research, however, has examined factors that may weaken the association between maladaptive coping, such as rumination, and depressive symptoms. In three samples of participants, including 149 never-depressed adolescent girls, 41 never-depressed women, and 39 depressed women, we examined whether generally adaptive forms of coping interacted with generally maladaptive forms of coping to predict depressive symptoms. Age-appropriate measures of coping and depression were administered to participants in each sample. In never-depressed females, maladaptive coping/rumination were more strongly related to depressive symptoms in the presence of lower levels of adaptive coping. The relation between depression and maladaptive coping/rumination was weaker in the context of higher levels of adaptive coping. In contrast, for the depressed females, we found main effects for rumination and adaptive coping, with higher levels of rumination and lower levels of adaptive coping being associated with higher levels of depressive symptoms. The present findings highlight how adaptive coping and maladaptive coping, including rumination, differentially relate to each other and depressive symptoms depending on individuals' current depressive state.     

Rumination, worry, cognitive avoidance, and behavioral avoidance: examination of temporal effects

Recently, cross-sectional research has demonstrated that depressive rumination is significantly associated with the tendency to engage in cognitive and behavioral avoidance. This evidence suggests that rumination may be the result of attempts to avoid personally threatening thoughts, in a manner suggested by multiple contemporary theories of worry. This investigation examined the temporal relationship among daily levels of cognitive avoidance, behavioral avoidance, rumination, worry, and negative affect. Seventy-eight adolescents completed baseline questionnaires and then electronically completed daily measures of rumination, worry, behavioral avoidance, and cognitive avoidance, as well as sad and anxious affect for 7 days. Lagged-effect multilevel models indicated that increases in daily sadness were predicted by greater daily rumination and cognitive avoidance. Increases in daily anxiety were predicted by greater daily rumination, worry, and both cognitive and behavioral avoidance. Further, both daily rumination and worry were positively predicted by daily cognitive, but not behavioral, avoidance. Mediation analyses suggested that rumination mediated the effect of cognitive avoidance on both sadness and anxiety. Also, worry mediated the effect of cognitive avoidance on anxiety. Implications for models of avoidance, rumination, and worry are discussed.     

Unique associations between anxiety,depression and motives for approach and avoidance goal pursuit

This study investigated the shared and distinct associations between depressive and anxious symptoms and motives for pursuing personal goals. One hundred and thirty-six undergraduates generated approach and avoidance goals and rated each on intrinsic, identified, introjected and external motives. Anxious and depressive symptoms showed significant unique associations with distinct motives. Specifically, depressive symptoms predicted significant unique variance in intrinsic motivation for approach goals (but not avoidance goals), whereas anxious symptoms predicted significant unique variance in introjected regulation for approach and avoidance goals. Some of these findings were moderated by gender. The findings broadly support the notion that depression is uniquely characterised by reduced enjoyment of approach goal pursuit whereas anxiety is uniquely characterised by pursuit of goals in order to avoid negative outcomes. We suggest that these findings are compatible with regulatory focus theory and suggest that motives for goal pursuit are important in understanding the relation between goals and specific mood disorder symptoms.     

Testing the cognitive catalyst model of depression: does rumination amplify the impact of cognitive diatheses in response to stress?

Recent studies have found that rumination functions as a catalyst of cognitive vulnerability to depression. Specifically, these studies have reported synergistic effects between rumination and negative cognitive content (beliefs and attitudes), such that rumination amplifies the association between negative cognitive content and depression (Ciesla & Roberts, 2002, 2007; Robinson & Alloy, 2003). The current study extended this work by testing whether cognitive vulnerability involving the combination of negative cognitive content and rumination increases the impact of stress on the course of depressive symptoms. One hundred ninety-one college students with elevated depressive symptoms participated in a two-wave longitudinal study. Results indicate that the maintenance of depressive symptoms was predicted by the three-way interaction of negative cognitive content, rumination, and stressful life events. More specifically, students who endorsed both maladaptive cognitive content and a tendency to ruminate were particularly vulnerable to the deleterious impact of life stress.     

Does Worrying Mean Caring Too Much? Interpersonal Prototypicality of Dimensional Worry Controlling for Social Anxiety and Depressive Symptoms

Worry, social anxiety, and depressive symptoms are dimensions that have each been linked to heterogeneous problems in interpersonal functioning. However, the relationships between these symptoms and interpersonal difficulties remain unclear given that most studies have examined diagnostic categories, not accounted for symptoms’ shared variability due to general distress, and investigated only interpersonal problems (neglecting interpersonal traits, interpersonal goals, social behavior in daily life, and reports of significant others). To address these issues, students (Study 1; N = 282) endorsed symptoms and interpersonal circumplex measures of traits and problems, as well as event-contingent social behaviors during one week of naturalistic daily interactions (N = 184; 7,036 records). Additionally, depressed and anxious patients (N = 47) reported symptoms and interpersonal goals in a dyadic relationship, and significant others rated patients’ interpersonal goals and impact (Study 2). We derived hypotheses about prototypical interpersonal features from theories about the functions of particular symptoms and social behaviors. As expected, worry was uniquely associated with prototypically affiliative tendencies across all self-report measures in both samples, but predicted impacting significant others in unaffiliative ways. As also hypothesized, social anxiety was uniquely and prototypically associated with low dominance across measures, and general distress was associated with cold-submissive tendencies. Findings for depressive symptoms provided less consistent evidence for unique prototypical interpersonal features. Overall, results suggest the importance of multimethod assessment and accounting for general distress in interpersonal models of worry, social anxiety, and depressive symptoms.     

Repetitive Thought and Self-Reported Sleep Disturbance

Repetitive thought has been focused upon as a transdiagnostic risk factor for depression, anxiety, and poor physical health. Among the forms of repetitive thought, rumination and worry are considered to play important roles in the onset and maintenance of insomnia. However, there have been few attempts to clarify the similarities, differences, and interaction between the functions of rumination and worry in sleep problems. Furthermore, no study has investigated the prospective relationships between these two forms of repetitive thought and sleep disturbance. In the present study, we examined the prospective associations between repetitive thought and subjective sleep quality, measured by a self-report questionnaire. A total of 208 undergraduates participated in a 2-wave longitudinal survey with an interval of 3 weeks between assessments. Hierarchical multiple regression analyses showed that baseline rumination predicted reduction in the follow-up assessment of subjective sleep quality, controlling for levels of depressive and anxious symptoms. This main effect of rumination was qualified by the levels of worry; for individuals with higher levels of worry, rumination was associated with greater reduction in subjective sleep quality. These results suggest that both rumination and worry have unique associations with sleep and that their interaction is especially important in sleep problems.     

The association of anxiety,depression, and worry symptoms on cognitive performance in older adults

Emerging research suggests that a relationship exists between the cognitive aspects of anxiety (e.g. worry) and cognitive decline in older adults. The current study examined the association between anxiety, depressive, and worry symptoms on cognitive performance. Participants were 156 older adults enrolled in the Nathan Kline Institute-Rockland Sample Study (NKI-RS). Hierarchical linear regression analysis was used to determine the unique associations of anxiety, depressive, and worry symptoms on cognitive performance as measured by the Penn Computerized Neurocognitive Battery (Penn CNB), the Delis-Kaplan Executive Function System (D-KEFS), and the Rey Auditory Verbal Learning Test (RAVLT). Worry symptoms were a significant predictor of Penn CNB social cognition, complex cognition, executive function, and episodic memory performance as well as RAVLT immediate and short-delay recall, but not of D-KEFS performance or RAVLT long-delay recall. In contrast, anxiety and depressive symptoms had few unique associations with cognitive performance. Given that worry symptoms have a negative impact on many aspects of neurocognitive performance, they may have utility in predicting and preventing cognitive decline in older adults.     

家庭压力源影响青少年抑郁体验:冗思的中介机制

采用方便抽样法从山东某初中和某高中抽取570名学生做问卷调查,考察家庭压力源对青少年抑郁体验的影响,特别是冗思作为应对方式的中介作用。路径分析的结果显示:(1)家庭冲突和父母期望均显著正向预测抑郁体验,且家庭冲突的预测作用更强,家庭规范对抑郁体验的预测作用不显著;(2)家庭冲突和父母期望均显著正向预测青少年冗思,家庭规范对冗思的预测作用不显著;(3)冗思显著正向预测抑郁体验;(4)冗思在家庭冲突与抑郁体验之间以及父母期望与抑郁体验之间均起中介作用。总体来看,冗思是家庭压力影响青少年抑郁体验的内部机制之一。     

Ruminative subtypes and coping responses: Active and passive pathways to depressive symptoms

Individuals draw on a variety of cognitive strategies—some active, some passive—as a way of coping with stress and dysphoria. Previous research suggests that the impact of rumination—one such strategy—on depression depends on whether rumination takes the passive form of brooding versus the more active form of reflection. This study tests whether brooding and reflection explain the effects of passive versus active coping responses, respectively, on depressive symptoms. In an undergraduate sample (n=284), brooding partially mediated the relationship between passive coping and depressive symptoms, whereas reflection did not. Reflection moderated the relationship between active coping and symptoms, such that low active copers who were high in reflection endorsed more symptoms than those low in reflection. Brooding and reflection may operate within cognitive–behavioural response pathways characterised by an active/passive distinction. Whether reflection is maladaptive likely depends on the active nature of the surrounding coping response.     

The response styles theory of depression: A test of specificity and causal mediation

This prospective study tested the diathesis-stress and causal mediation components of the response styles theory of depression. In addition, it examined whether rumination predicts increases in anxious as well as depressive symptoms. At Time 1, 87 college students completed measures of rumination, hopelessness, depressive symptoms, and anxious symptoms. Participants also completed measures of hopelessness, depressive symptoms, and anxious symptoms at three time points later in the semester: immediately after receiving their most difficult midterm exam grade (Time 2), 4–8 hours later (Time 3), and 4 days later (Time 4). Regardless of exam outcome, the tendency to ruminate in response to depressed mood was associated with: (1) increases in anxious symptoms between Time 1 and Time 3; and (2) increases in both anxious and depressive symptoms between Time 1 and Time 4. In addition, the relationship between rumination and increases in both depressive and anxious symptoms was mediated by hopelessness. In other words, individuals with a ruminative response style exhibited increases in both depressive and anxious symptoms because they exhibited increases in hopelessness.     

Adult attachment dimensions and specificity of emotional distress symptoms: prospective investigations of cognitive risk and interpersonal stress generation as mediating mechanisms

Three prospective studies examined the relation between adult attachment dimensions and symptoms of emotional distress (anxiety and depression). Across all three studies, avoidant and anxious attachment prospectively predicted depressive symptoms, and anxious attachment was associated concurrently with anxiety symptoms. Study 2 tested a cognitive risk factors mediational model, and Study 3 tested an interpersonal stress generation mediational model. Both cognitive and interpersonal mediating processes were supported. The cognitive risk factors pathway, including elevated dysfunctional attitudes and low self-esteem, specifically mediated the relation between insecure attachment and prospective elevations in depression but not anxiety. For the interpersonal stress generation model, experiencing additional interpersonal, but not achievement, stressors over time mediated the association between insecure attachment and prospective elevations in depressive and anxious symptoms. Results advance theory and empirical knowledge about why these interpersonal and cognitive mechanisms explain how insecurely attached people become depressed and anxious.     

The effects of worry and rumination on affect states and cognitive activity

The effects of worry and rumination on affective states and mentation type were examined in an unselected undergraduate sample in Study 1 and in a sample of individuals with high trait worry and rumination, high rumination, and low worry/rumination in Study 2. Participants engaged in worry and rumination inductions, counterbalanced in order across participants to assess main and interactive effects of these types of negative thinking. During mentation periods, the thought vs. imaginal nature and the temporal orientation of mentations were assessed 5 times. Following mentation periods, negative and positive affect, relaxation, anxiety, and depression were assessed. Both worry and rumination produced increases in negative affect and decreases in positive affect. Worry tended to generate greater anxiety, and rumination tended to generate greater depression. Interactive effects were also found indicating that worry may lessen the anxiety experienced during subsequent rumination. Moreover, worry lessened the depressing effects of rumination. Worry was associated with significantly greater thought than imagery, compared to rumination. Rumination involved a progression from mentation about the past to mentation about the future over time. Implications for understanding the generation of negative affect and comorbid anxiety and depression are discussed.     

The effects of rumination and negative cognitive styles on depression: a mediation analysis

Research on cognitive models of depression has identified negative cognitive styles and rumination as risk factors for depression. The present study examined the hypothesis that rumination mediates the effect of negative cognitive styles on depression. Specifically, we evaluated the differential effects of two aspects of rumination, characterized by brooding and reflection, on the relationship between negative cognitive styles and level of depressive symptoms. A total of 115 college students and 38 patients suffering from depressive disorders completed a battery of questionnaires measuring levels of depressive symptoms, brooding, reflection, and negative cognitive styles. The results support the notion that there exist two distinct dimensions of rumination and that, of the two, it is brooding and not reflection that mediates the relationship between negative cognitive styles and depression and contributes to its negative outcomes.     

Examining the role of positive and negative metacognitive beliefs in depression

Many psychological models have been developed to explain the development and maintenance of depression. The most widely evaluated model is the cognitive model of depression, and it is against this model that emerging models should be compared. Accordingly, this cross‐sectional study examined whether metacognitive beliefs, as specified in the metacognitive model of depression, would explain additional variance in depressive symptoms over dysfunctional attitudes; the core feature of the cognitive model. Moreover, mediational relationships between metacognitive beliefs, rumination, and depressive symptoms, predicted by the metacognitive model were also explored, whilst controlling for dysfunctional attitudes. A sample of 715 students completed self‐report questionnaires measuring depressive symptoms, rumination, dysfunctional attitudes, and metacognitive beliefs. Regression analyses showed that metacognitive beliefs made a significant statistical contribution to depressive symptoms, after controlling for age, gender, rumination and dysfunctional attitudes. Furthermore, as predicted by the metacognitive model, the relationship between positive metacognitive beliefs and depressive symptoms was fully mediated by rumination, whilst the relationship between negative metacognitive beliefs about uncontrollability and danger and depressive symptoms was partially mediated by rumination. The results provide further empirical support for the metacognitive model of depression and indicate that positive and negative metacognitive beliefs play an integral role in the maintenance of depressive symptoms.     

Rumination and worrying as possible mediators in the relation between neuroticism and symptoms of depression and anxiety in clinically depressed individuals

Rumination and worrying are considered possible mediating variables that may explain the relation between neuroticism and symptoms of depression and anxiety. The current study sought to examine the mediational effects of rumination and worry in the relationships between neuroticism and symptoms of depression and anxiety in a sample of clinically depressed individuals (N = 198). All patients completed a battery of questionnaires including measures of neuroticism, rumination, worrying, depression, and anxiety. Results showed that in subsequent analyses, rumination and worrying both mediated the relation between neuroticism and depression and anxiety. When rumination and worrying were simultaneously entered in the mediation analysis, only rumination was found to mediate the relation between neuroticism and symptoms of anxiety and depression. Two components of rumination (i.e., brooding and reflection) were also analyzed in the mediational analysis. Both reflection and brooding were significant mediators with respect to depressive symptoms, whereas brooding was the only significant mediator in relation to anxiety symptoms. The results are discussed in the light of current theories, previous research, and recent treatment developments. Clinical implications and suggestions for future research are provided.     

Responses to Positive Affect in Daily Life: Positive Rumination and Dampening Moderate the Association Between Daily Events and Depressive Symptoms

Depressive rumination has been strongly linked to the development and maintenance of depression; however, less attention has been paid to ruminative processes in response to positive affect, and fewer have examined these processes in daily life. The current study sought to address these gaps by exploring depressive rumination and two forms of responses to positive affect, dampening and positive rumination, under ecologically valid conditions using daily diary methodology. One hundred fifty-seven young adults completed 14-day end-of-day diaries assessing positive affect and depressive symptoms in relation to depressive rumination, responses to positive affect, and daily positive and negative events. Daily depressive rumination predicted stronger associations between negative events and daily depressive symptoms. Higher daily dampening was associated with higher daily depressive symptoms and decreased positive affect and predicted lower associations between daily positive events and improvements in mood (including reduced daily positive affect and increased daily depressive symptoms). Higher daily positive rumination was negatively associated with daily depressive symptoms and interacted with daily positive events such that positive rumination had a greater impact on depressed mood on days when positive experiences were low. Results indicate that both depressive rumination and responses to positive affect play a role in influencing daily mood and depressive symptoms.     

受欺负对抑郁情绪的影响:悲伤、愤怒反刍的中介作用及性别差异

为探究受欺负对于个体抑郁情绪的影响,以及反刍这一认知因素在其中的作用与性别差异,采用受欺负问卷、儿童应对方式问卷中的悲伤反刍分量表、愤怒反刍问卷、儿童抑郁量表对2582名初中二年级学生（男生1328人,女生1254人;平均年龄13.95岁,SD=0.60）进行问卷调查。结果发现：（1）受欺负与悲伤反刍、愤怒反刍、抑郁情绪均呈显著正相关;（2）受欺负、悲伤反刍、愤怒反刍均可显著正向预测个体的抑郁情绪,且悲伤反刍和愤怒反刍在受欺负和抑郁情绪的关系中发挥部分中介作用;（3）该模型存在性别差异。女生悲伤反刍对抑郁情绪的预测作用显著大于男生。研究从悲伤反刍和愤怒反刍的角度揭示了受欺负对青少年抑郁情绪的作用机制,为从认知水平上干预青少年心理健康问题提供了参考。     

Distinguishing between level and impact of rumination as predictors of depressive symptoms: An experience sampling study

Rumination—repetitively thinking about one's emotional state, its causes and consequences—exacerbates negative mood and plays an important role in the aetiology and maintenance of depression. Yet, it is unclear whether increased vulnerability to depression is associated with simply how much a person ruminates, or the short-term impact rumination has on a person's negative mood. In the current study, we distinguish between the level versus the impact of rumination, and we examine how each uniquely predicts changes in depressive symptoms over time in an undergraduate sample. Using experience sampling, we assessed students’ (N = 101) subjective experiences of positive and negative affect and their use of rumination and distraction in daily life for seven days. Participants also reported their depressive symptoms before and after the experience sampling. Increases in depressive symptoms over the week were predicted by how much people ruminated, but not by its impact on negative mood.